Pott's puffy tumor is

POTT'S PUFFY TUMOUR It is formation of diffuse external swelling in the scalp due to subperiosteal pus formation (abscess) and scalp oedema. x It originates commonly in frontal region and may extend into other regions. x There is acute osteomyelitis of frontal bone. Causes x Chronic frontal sinusitis which eventually suppurates and extends into subperiosteal region. x Trauma--subperiosteal haematoma. x Chronic suppurative otitis media. Features x Pain and boggy swelling in frontal region which is warm, tender. x Toxicity and drowsiness. x Pitting scalp oedema is typical. x Investigations:  Total leucocyte count--increased. ESR--raised.  X-ray skull. CT scan. x Differential diagnosis: Secondaries in the skull or brain. Complications Osteomyelitis of frontal bone. Spread of infection into intracranial cavity leads to intracranial abscess (Extradural or subdural abscess) (dumb-bell abscess). So may present with features of raised intracranial tension like headache, coning and convulsions. Pott's Puffy tumor can be associated with coical vein throm- bosis, epidural brain abscess/subdural empyema. The cause of vein thrombosis is explained by diplopic veins in frontal bone, which communicates with the dural venous plexus; septic thrombi can potentially evolve from foci within the frontal sinus and propagate through this venous system. Treatment x Antibiotics and drainage under general anaesthesia before it spreads into cranial cavity. x Once it extends into cranial cavity, it is treated accordingly by formal neurosurgical decompression (often using Dandy's brain cannula). x Osteomyelitis of skull bones requires radical removal with recon- struction of skull defect. Ref: SRB manual of surgery 5th edition Pgno: 48